Healthcare Provider Details

I. General information

NPI: 1275235129
Provider Name (Legal Business Name): ANISH DOSHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 POTOMAC AVE APT 542
ALEXANDRIA VA
22301-3077
US

IV. Provider business mailing address

650 POTOMAC AVE APT 542
ALEXANDRIA VA
22301-3077
US

V. Phone/Fax

Practice location:
  • Phone: 434-466-1867
  • Fax:
Mailing address:
  • Phone: 434-466-1867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number13595
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401419972
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: